Eric Ricardo Yonatan, Louis Fabio Jonathan Jusni, Steven Alvianto, Nicolas Daniel Widjanarko, Steven Yulius Usman, Virly Nanda Muzellina
{"title":"肠促胰岛素为基础的治疗是否影响2型糖尿病患者胆管癌的风险？来自系统回顾和元分析的见解。","authors":"Eric Ricardo Yonatan, Louis Fabio Jonathan Jusni, Steven Alvianto, Nicolas Daniel Widjanarko, Steven Yulius Usman, Virly Nanda Muzellina","doi":"10.1007/s12029-025-01330-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), are widely used in the management of type 2 diabetes mellitus (T2DM). However, concerns have emerged regarding their potential association with an increased risk of cholangiocarcinoma (CCA), and current evidence remains inconclusive. This review aims to evaluate and clarify the association between incretin-based therapies and the risk of CCA in patients with T2DM.</p><p><strong>Methods: </strong>This review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025641616). A comprehensive search was performed across PubMed, ProQuest, EBSCOhost, Wiley, and SAGE databases. Eligible observational studies reporting the association between incretin-based therapies and CCA were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using RevMan with a random-effects model.</p><p><strong>Result: </strong>Four studies (three cohort and one case-control) were included. The pooled HRs showed no significant association between incretin-based therapies and CCA risk, with estimates of 1.07 (95% CI: 0.70-1.63) for GLP-1RAs and 1.05 (95% CI: 0.83-1.34) for DPP-4Is. Pooled RR analyses yielded similarly non-significant results. All included studies were assessed as having a low risk of bias according to the NOS.</p><p><strong>Conclusion: </strong>Incretin-based therapies do not significantly increase the risk of CCA in T2DM patients. Within the limitations of the available observational evidence, these findings provide reassurance regarding their safety profile, while highlighting the need for ongoing pharmacovigilance and further large-scale studies to confirm these results.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"198"},"PeriodicalIF":1.6000,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Do Incretin-Based Therapies Influence the Risk of Cholangiocarcinoma in Type 2 Diabetes Patients? Insights from a Systematic Review and Meta-Analysis.\",\"authors\":\"Eric Ricardo Yonatan, Louis Fabio Jonathan Jusni, Steven Alvianto, Nicolas Daniel Widjanarko, Steven Yulius Usman, Virly Nanda Muzellina\",\"doi\":\"10.1007/s12029-025-01330-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), are widely used in the management of type 2 diabetes mellitus (T2DM). However, concerns have emerged regarding their potential association with an increased risk of cholangiocarcinoma (CCA), and current evidence remains inconclusive. This review aims to evaluate and clarify the association between incretin-based therapies and the risk of CCA in patients with T2DM.</p><p><strong>Methods: </strong>This review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025641616). A comprehensive search was performed across PubMed, ProQuest, EBSCOhost, Wiley, and SAGE databases. Eligible observational studies reporting the association between incretin-based therapies and CCA were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using RevMan with a random-effects model.</p><p><strong>Result: </strong>Four studies (three cohort and one case-control) were included. The pooled HRs showed no significant association between incretin-based therapies and CCA risk, with estimates of 1.07 (95% CI: 0.70-1.63) for GLP-1RAs and 1.05 (95% CI: 0.83-1.34) for DPP-4Is. Pooled RR analyses yielded similarly non-significant results. All included studies were assessed as having a low risk of bias according to the NOS.</p><p><strong>Conclusion: </strong>Incretin-based therapies do not significantly increase the risk of CCA in T2DM patients. Within the limitations of the available observational evidence, these findings provide reassurance regarding their safety profile, while highlighting the need for ongoing pharmacovigilance and further large-scale studies to confirm these results.</p>\",\"PeriodicalId\":15895,\"journal\":{\"name\":\"Journal of Gastrointestinal Cancer\",\"volume\":\"56 1\",\"pages\":\"198\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-10-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastrointestinal Cancer\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12029-025-01330-9\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastrointestinal Cancer","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12029-025-01330-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Do Incretin-Based Therapies Influence the Risk of Cholangiocarcinoma in Type 2 Diabetes Patients? Insights from a Systematic Review and Meta-Analysis.
Introduction: Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), are widely used in the management of type 2 diabetes mellitus (T2DM). However, concerns have emerged regarding their potential association with an increased risk of cholangiocarcinoma (CCA), and current evidence remains inconclusive. This review aims to evaluate and clarify the association between incretin-based therapies and the risk of CCA in patients with T2DM.
Methods: This review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025641616). A comprehensive search was performed across PubMed, ProQuest, EBSCOhost, Wiley, and SAGE databases. Eligible observational studies reporting the association between incretin-based therapies and CCA were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using RevMan with a random-effects model.
Result: Four studies (three cohort and one case-control) were included. The pooled HRs showed no significant association between incretin-based therapies and CCA risk, with estimates of 1.07 (95% CI: 0.70-1.63) for GLP-1RAs and 1.05 (95% CI: 0.83-1.34) for DPP-4Is. Pooled RR analyses yielded similarly non-significant results. All included studies were assessed as having a low risk of bias according to the NOS.
Conclusion: Incretin-based therapies do not significantly increase the risk of CCA in T2DM patients. Within the limitations of the available observational evidence, these findings provide reassurance regarding their safety profile, while highlighting the need for ongoing pharmacovigilance and further large-scale studies to confirm these results.
期刊介绍：
The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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